推拿联合运动疗法治疗老年性膝骨关节炎60例

正膝骨关节炎是老年人的一种常见的关节疾病,主要病理改变为软骨退行性变性和消失,以及关节边缘韧带附着处和软骨下骨质反应性增生形成骨赘,并由此引起关节疼痛、僵直畸形和功能障碍。本文采用推拿联合运动疗法治疗老年膝骨关节炎,观察其疗效。     

大骨节病关节软骨真菌毒素环境反应基因表达谱研究

目的 比较分析真菌毒素环境反应基因在大骨节病(Kashin-Beck disease,KBD)和正常关节软骨中的表达谱差异,探讨真菌毒素环境反应基因与KBD软骨损伤的关系.方法 采集9例KBD患者和9例正常对照关节软骨样本,提取总RNA.采用Agilent基因表达芯片评估真菌毒素环境反应基因在软骨样品中的表达量,并计算每个基因在KBD和正常对照软骨中表达量的比率(简称表达率).采用GSEA软件计算每个基因功能分类表达量的NES指数及P值.结果 ①T-2毒素、脱氧镰刀菌烯醇、玉米赤霉烯酮、黄曲霉毒素B1、伏马菌素B1和赫曲霉毒素A相关的15个环境反应基因在KBD和正常对照关节软骨中的表达水平存在差异(表达率＞2.0或＜0.5),其中13个基因在KBD软骨中上调,包括BAX、BCL2、COL5A2、FER1L3、GSTT2、IGFBP2、IGFBP4、PDE8B、SOCS3、THBS1、TMSL8、VGLL3和TUBB2A(表达率＞2.0);2个基因在KBD软骨中下调,包括POSTN和FABP4(表达率＜0.5).上述15个基因功能主要涉及胶原、细胞凋亡、代谢和生长发育等.②真菌毒素相关的4个凋亡基因功能分类和5个生长发育基因功能分类在KBD关节软骨中上调(NES＞0),包括ANTI_APOPTOSIS、REGULATION OF PROGRAMMED_CELL_DEATH、APOPTOSIS_GO、EGULATION_OF_APOPTOSIS、ORGAN MORPHOGENES IS、ANATOMICAL_STRUCTURE_ DEVELOPMENT、ORGAN_DEVELOPMENT、SYSTEM DEVELOPMENT和REGULATION—OF_DEVELOPMENTAL_PROCESS (NES＞0且P＜ 0.05).结论 KBD软骨中存在多种真菌毒素的环境反应基因表达且显著不同于正常对照,提示真菌毒素可能通过影响相关环境反应基因在关节软骨中的表达,诱发软骨细胞功能障碍和关节软骨损伤.     

中医药疗法治疗膝骨关节炎的机理研究进展

膝骨关节炎（kneeosteoarthritis,KOA）是慢性、渐进性、退行性关节病变,是老年人的常见疾病,主要表现为膝关节软骨退变、磨损、骨刺形成,由此导致膝关节肿胀、疼痛、畸形和功能障碍等。随着人口老龄化的加剧,     

玻璃酸钠治疗老年膝关节骨关节病的临床观察

骨性关节病(OA),是一种非炎症性慢性进行性关节疾病[1],以关节软骨的变性、磨损、退变和关节边缘及软骨下区的骨质增生为特征,是最常见的一种关节病。膝关节骨关节病在老年人中较为常见,严重影响了老年人正常的生活,有较高的致残率。目前,临床上治疗膝关节骨关节病的方法较为有     

维生素对骨关节炎影响的研究进展

<正>骨关节炎(osteoarthritis,OA)作为一种慢性疾病,是目前导致全球老年人身体残疾及生活质量下降的主要原因。OA主要影响负重关节,其中以手、膝关节最为常见,主要病理表现为习惯性负重部位的滑膜炎症及软骨下骨损伤,严重者可形成骨赘,可引起受累关节的疼痛、肿胀、活动受限、骨擦音及骨擦感等,关节腔可有不同程度的渗出性炎症,而全身症状较为少见。OA多见于老年人,目前致病     

老年骨性关节炎与关节软骨酶降解

骨性关节炎是老年人常见的关节退行性疾病,近年来通过动物实验及临床研究,发现骨性关节炎关节软骨的破坏与软骨中或滑膜中中性蛋白酶及胶元酶降解软骨中的主要成份有关。对实验动物给予酶拮抗剂能显著减轻实验动物关节软骨的破坏,如果通过进一步研究应用于临床,将为治疗及预防骨性关节炎这一顽疾开辟一个新的途径。     

关节镜下修复关节软骨损伤

关节软骨缺乏血液供应,细胞代谢缓慢,损伤后难以自行修复。即使比较小的软骨损伤也可能产生比较显著的症状如疼痛、肿胀、功能障碍,最终发生关节的退行性变。软骨损伤在运动员和老年人中非常普遍。CURL等统计了31516个膝关节镜检查结果,约63％的患者存在软骨损伤。关节镜检查在临床上被视为诊断关节软骨损伤的金标准,可以准确的观察到关节内的软骨病变,并进行处理。现将关节软骨损伤的关节镜下修复情况总结如下。     

氨基葡萄糖与美洛昔康治疗老年膝骨关节炎疗效的对比观察

骨关节炎(OA)是一种常见的难治性骨关节疾患,以关节软骨破坏为主要特点.膝关节作为负重关节为最易受累的关节之一,已成为危害老年人身心健康的主要疾病之一.OA的传统治疗方法是非甾体抗炎药、关节内注射以及物理治疗等,其中特异性环氧化酶-2(COX-2)抑制剂胃肠道反应小,被多数患者接受;同时,近年来改善软骨代谢的药物受到国内外学者的普遍重视[1].本文报道具有改善软骨代谢作用的药物硫酸氨基葡萄糖治疗老年膝关节OA患者,并与美洛昔康进行对照,观察两者的疗效和药物耐受性.     

老年性骨关节病的磁共振成像检查

骨性关节病 (osteoarthrosis,OA) ,又称退行性骨关节病 (degen erativeosteoarthrosis)、骨关节炎 (os teoarthritis)、肥大性关节炎 (hyper trophicarthritis) ,是一种非炎症性慢性进行性关节疾病 ,多见于老年人 ,是最常见的一种关节病。以上关节软骨的变性、磨损、退变和关节边缘及软骨下区的骨增生为特征 ,也可形成软骨下囊肿、滑膜和关节囊增厚 ,关节内游离体以及骨刺形成。1　骨性关节病的MRI近年来随着磁共振成像 (MRI)的广泛应用 ,对OA的诊断有了很大的提高 ,能直接显示关节软骨、关节囊、滑膜等组织 ,对OA的分型、治疗方法的选…     

类风湿关节炎诊治指南(草案)

1　概　　　述类风湿关节炎 (ｒｈｅｕｍａｔｏｉｄａｒｔｈｒｉｔｉｓ,ＲＡ)是一种病因不明的自身免疫性疾病 ,多见于中年女性 ,我国患病率约为0 32 %～ 0 36 %。主要表现为对称性、慢性、进行性多关节炎。关节滑膜的慢性炎症、增生 ,形成血管翳 ,侵犯关节软骨、软骨下骨、韧带和肌腱等 ,造成关节软骨、骨和关节囊破坏 ,最终导致关节畸形和功能丧失。2　临床表现2 1　症状和体征 :病情和病程有个体差异 ,从短暂、轻微的少关节炎到急剧进行性多关节炎。受累关节以近端指间关节、掌指关节、腕、肘、肩、膝和足趾关节最为多见 ;颈椎、颞颌…     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.